ON-Q pain relief pump, double silver type at BSA Hospital

Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.

Model: claude-sonnet-5-5
Provider: anthropic
API: message_batches
Reasoning effort: model default
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

SYSTEM DRUG DELIVERY ON-Q PAINBUSTER SILVERSOAKER DEHP 4 ML/HR L2.5 IN 270 ML NONNARCOTIC 2 SITE CATHETER ELASTOMERIC STERILE BATHE SURGICAL SITE MEDICATION

Amarillo, TX

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How this price compares nationally

BSA Hospital’s median price of $612 is 4% above the median hospital's median price ($591), higher than 53% of the 398 hospitals reporting HCPCS C9804. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS C9804 at BSA Hospital

Negotiated rates from the hospital’s own file: 9 payers, 19 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.

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#
1	Aetna aetna better health [351001] facility · percent of total billed charges · bothfrom % of charges	$341	$341	—	—	—	$341 – $341
2	Cigna cigna healthspring medicaid replacement [394500] facility · percent of total billed charges · bothfrom % of charges	$341	$341	—	—	—	$341 – $341
3	Healthcare Highways hch 90 degree benefits [221013] facility · percent of total billed charges · bothfrom % of charges	$341	$341	—	—	—	$341 – $341
4	Healthcare Highways hch broken arrow [221012] facility · percent of total billed charges · bothfrom % of charges	$341	$341	—	—	—	$341 – $341
5	Healthcare Highways hch john soules foods [221011] facility · percent of total billed charges · bothfrom % of charges	$341	$341	—	—	—	$341 – $341
6	UnitedHealthcare uhc comm mcaid health pla [225001] facility · percent of total billed charges · bothfrom % of charges	$341	$341	—	—	—	$341 – $341
7	UnitedHealthcare uhc medicaid community plan [375501] facility · percent of total billed charges · bothfrom % of charges	$341	$341	—	—	—	$341 – $341
8	Cigna cigna pantex [126003] facility · percent of total billed charges · bothfrom % of charges	$411	$411	—	—	—	$411 – $411
9	Aetna aetna client specific [101506] facility · percent of total billed charges · bothfrom % of charges	$568	$568	—	—	—	$568 – $568
10	Medica medica harmony [291000] facility · percent of total billed charges · bothfrom % of charges	$612	$612	—	—	—	$612 – $612
11	Phcs freedom life [178009] facility · percent of total billed charges · bothfrom % of charges	$612	$612	—	—	—	$612 – $612
12	Phcs phcs multiplan [178000] facility · percent of total billed charges · bothfrom % of charges	$612	$612	—	—	—	$612 – $612
13	Cigna cigna [126008] facility · percent of total billed charges · bothfrom % of charges	$635	$635	—	—	—	$635 – $635
14	Healthpartners healthpartners [150000] facility · percent of total billed charges · bothfrom % of charges	$635	$635	—	—	—	$635 – $635
15	UnitedHealthcare united healthcare shared svcs [206010] facility · percent of total billed charges · bothfrom % of charges	$636	$636	—	—	—	$636 – $636
16	Aetna american continental [101507] facility · percent of total billed charges · bothfrom % of charges	$656	$656	—	—	—	$656 – $656
17	Aetna meritain aetna [368500] facility · percent of total billed charges · bothfrom % of charges	$656	$656	—	—	—	$656 – $656
18	Kaiser kaiser permanete oakland ca [156000] facility · percent of total billed charges · bothfrom % of charges	$743	$743	—	—	—	$743 – $743
19	MultiPlan international benefits administrators [168005] facility · percent of total billed charges · bothfrom % of charges	$743	$743	—	—	—	$743 – $743

Last updated: Feb 12, 2026

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